California's workers' compensation laws focus on injuries and illnesses suffered by individuals during the course of their employment. The state requires employers who have 15 or more workers to purchase workers' compensation insurance. This is a no-fault insurance that reimburses workers for medical expenses and a portion of lost wages regardless of whose fault the accident was.
While workers' compensation offers some type of reimbursement to injured employees, it also prohibits employees from filing a lawsuit against their employers. It is important to know what your rights and responsibilities under California's workers' compensation laws.
What Are the Important Deadlines?
Here are some important deadlines employees and employers should remember:
- An employee has 30 days to give written notice of the work-related injury to an employer.
- An employer must provide the employee with a claim form within 1 day of receiving notice of the injury.
- An employee has 1 year to file a workers' compensation claim.
What Types of Workers' Comp Benefits Are Available?
California's division of workers' compensation states that workers who are injured on the job are entitled to the following benefits:
Medical care: Typically, workers can get treatment for their injuries by going to a doctor who is part of the employer's insurance company's provider network. Under workers' comp law, medical care must go through what is known as a "utilization review," which is a review of the appropriate treatment for each type of injury. Injured employees are also entitled to mileage reimbursement for travel related to medical treatment and care.
Temporary disability: Benefits for temporary disability are payments made to the injured worker for his or her inability to work due to the injury. The rate is two-thirds of the worker's weekly wage. Temporary disability benefits are limited to 104 weeks within five years of the date of injury.
Permanent disability: These benefits are calculated based on permanent loss of function. This is paid on a weekly basis for a set amount of time depending on the employee's level of disability. The maximum weekly rate is $290 a week.
Worker retraining: Supplemental job displacement benefits are for an injured worker who is unable to return to work even after his or her condition is stabilized. The worker receives a voucher for $6,000 for retraining. The injured worker can get additional benefits in the form of a penalty that the insurance company must pay for any benefit that is paid late. The penalty can be up to 25% of the amount it is late in paying.
Death benefits: These are payments made to a spouse, children or other dependents when an employee dies from a work-related injury or illness. Death benefits include burial expenses not exceeding $5,000 for injuries before Jan. 1, 2013 and $10,000 for injuries on or after Jan. 1, 2013. The amount of death benefits depends on the number of total or partial dependents.
What Are the Employer's Obligations?
Employers are required under California law to provide workers' compensation benefits to all employees. There are very limited exceptions to this law. Within one day of notice of injury, an employer must provide a claim form and authorize medical treatment while the claim is pending. The injury is presumed covered if the claim is not rejected within 90 days.
Employers are also prohibited from retaliating against employees for filing a workers' compensation claim. Retaliation can come in several forms. A demotion, a pay cut, change in job responsibilities, unwarranted discipline and job termination are all examples of retaliation. Under California law, employers are prohibited from retaliating against an employee for filing a workers' comp claim.
Employees are guaranteed rights under the law that when they are injured on the job, they are entitled to receive medical treatment and lost wages from the employer, regardless of whose fault the accident was. By preventing an employer from taking adverse action against employees for attempting to collect workers' comp benefits, the law is protecting employees' rights to seek workers' compensation.
What is the Process?
If you have suffered a work-related injury, it is important to first seek emergency medical attention if necessary or to go to an approved medical provider and let them know that your injury is job-related. You must also give signed, written notice of your injury to your employer within 30 days. If you fail to provide this notice of injury within the required time, you may risk losing your right to receive any benefits. You also have one year to file your claim.
Your employer or claim administrator must authorize the appropriate medical treatment within one day of receiving the claim form. The employee may receive up to $10,000 in medical treatment while the insurance company deliberates. If the claim is not denied within 90 days, it must be presumed that the injury will be covered.
If your workers' comp claim is denied, you have the right to be heard by a judge. You must file an Application for Adjudication of Claim with required documents, give notice to the other parties, and file a Declaration of Readiness to Proceed. Your case will be scheduled for a mandatory settlement conference. If the case is not settled there, you will have to prepare documents describing the dispute. Your documents must identify the names of witnesses who will testify and what you will present at the trial. In such cases, it might be in your best interest to retain the services of an experienced Los Angeles work injury lawyer.
How an Experienced Lawyer Can Help
If you have been injured on the job, the experienced Los Angeles work injury lawyers at Greenberg & Ruby can help you explore other options such as filing a third-party claim. A lawsuit against a third party is usually worth a lot more than a workers' compensation claim. Third-party lawsuits are typically filed against entities such as general contractors, sub-contractors, property owners and manufacturers of defective products. Unlike workers' comp claims third-party lawsuits cover damages such as lost future income, loss of earning capacity, ongoing treatment costs and pain and suffering. Call us at (323) 782-0535 for a free, comprehensive and confidential consultation.